www.standard-club.

com

Standard Safety:
Seafarer Wellbeing
October 2018

The Standard
for service and security

Introduction
Welcome to this special edition of Standard Safety
on seafarer wellbeing

Yves Vandenborn
Director of Loss Prevention
T +65 6506 2852
E yves.vandenborn@ctplc.com

Contents
2 The Standard Club enhanced PEME
scheme - three years of operation
6 Seafarer health and operational
effectiveness
8 Food for thought
10 Calorie control
12 Victualling in the modern maritime
industry
14 Keeping fit to succeed
16 Keeping in shape on board
18 Incentivisation, motivation and
wellbeing
20 Seafarer mental health: A rising tide
22 Post-traumatic stress disorder (PTSD)
and the seafarer
24 Why screening does not work but peer
support does
26 The risks and rewards of seafaring in
the digital age
28 The human element - the effects of
fatigue on ship safety
30 Charities which can provide support for
seafarers
31 Commercial organisations which can
provide services related to seafarer
welfare
Over the last couple of years, the
club has been working on a variety of
projects related to seafarer wellbeing,
culminating in this special edition.
Seafarer wellbeing is a holistic concept
combining physical, mental and social
wellbeing, and our mix of articles reflects
this. People regularly forget how mental
and physical wellbeing are linked. If
you don’t feel good in your body, you
are likely not going to be happy either
and any small additional stress may
quickly result in a depressed feeling.
The Standard Club’s ‘people claims’
statistics indicate a clear upward trend
of mental health related illnesses.
We start off this special edition with an
analysis of The Standard Club’s enhanced
PEME scheme over its first three years
of operation. This flows directly into
an article on the effects of untreated
diabetes, hypertension or obesity on
a seafarer’s performance and how this
may impact the safe operation of a ship.
The next three articles delve deeper
into the nutritional aspects of physical
wellbeing. What effect has the
MLC 2006 had on the quantity and
quality of food for seafarers? What
is an ideal calorie count for different
seafarers? What are the benefits or
disadvantages of the different types of
victualling available to shipowners?
Apart from eating healthily, seafarers
should be encouraged to carry out
sufficient exercise on board, and our
next three articles discuss different
ways of keeping fit on board and how
seafarers can be incentivised.
As mentioned, the club sees a clear rising
tide when it comes to mental health
related illnesses. We discuss this problem
in our next article, and look at the risk
factors involved and what resources exist
to help seafarers suffering from mental
illness or post-traumatic stress disorder.
We are frequently asked whether
screening for mental health prior to
joining ship would help in reducing the
risk of incidents. We discuss this and
suggest a better alternative in the
form of mental health champions.
Concurrent with the rise of mental health
related illnesses, we have seen onboard
communication and connectivity become
more widely available for seafarers. Are
these two linked? How does social media
affect the mental wellbeing of seafarers?
Finally, our last article gives practical
advice to seafarers on managing and
dealing with fatigue on board.
We hope you will enjoy reading our special
edition on seafarer wellbeing and that
we can work together on improving
the wellbeing of our seafarers!
The Standard Club enhanced PEME scheme
– three years of operation

The club’s pre-employment medical examination

scheme has conducted thousands of PEME
examinations since its establishment in 2015. But 
what were the drivers which led to the creation of
the scheme and what have we learned after nearly
three years of the scheme’s operation?

Drivers of the scheme

In 2014, The Standard Club’s loss
prevention department analysed
the club’s personal illness claims for The club’s enhanced PEME
the prior five policy years, in order to scheme is designed to give
establish how these could be reduced.
members the confidence that
This provided valuable insight into
the club’s personal illness trends. they are aware of all of the risks
associated with employing a
Unsurprisingly, because of the particular crewmember.
composition of seafarer supply
Richard Bell worldwide, Filipino seafarers had
Loss Prevention Executive the highest number of personal
T +44 20 7680 5635 illness claims.
M +44 7919 492 718
E richard.bell@ctplc.com

Number of crew claims 2010–2015

1 40%
1 Filipino
2 Italian 9%
3 Indian 8%
4 Chinese 4%
10
5 Ukrainian 3%
9
8 6 Turkish 3%
7 7 German 3%
6
8 American 3%
5
4 2 9 Indonesian 3%
3
10 Others 24%

2
Every P&I club’s personal illness
statistics will comprise a mixture of
illnesses that could not be predicted
or prevented and manifestations
of chronic treatable illnesses.
Claims analysis was undertaken
to identify how many Filipino claims
were the result of the chronic,
detectable, treatable illnesses.
Approximately 50% of the most
commonly recorded conditions
may have been detected by an
enhanced PEME scheme, provided
the condition was present at the
time of the PEME, particularly in
the case of claims involving:
• cardiac-related problems
• heart attacks
• hypertension
• kidney stones.
Filipino crew claims causation 2010–2015
1 Appendicitis 18%
1
10
14%
2 Abdominal pain
9
3 Back pain 11%
8 2 4 Cardiac related 11%
5 Hernia 9%
6 Hemorrhoids 8%
7
7 Heart attack 8%
3 8%
8 Kidney stones
6
9 Hypertension 7%
5 4
10 Muscular/skeletal 6%
These four conditions alone 1. ensure that seafarers with
represented 34% of claims amongst detectable and treatable conditions
the top ten most commonly recorded were identified at the PEME stage
conditions for Filipino seafarers. so that they could seek medical
treatment before suffering
Based on this claims evidence, The irreversible damage to their health.
Standard Club engaged with Medical 2. ensure that members could make
Rescue International (MRI) to create an an informed decision on the
enhanced PEME scheme comprising employment of their seafaring staff.
11 clinics in the Philippines. The main 3. achieve an accumulative
objectives of the scheme were to: improvement in the health
of participating members’
seafarers over time.
3
What have we learned? Unfit group, job role: years 1 to 3
Since the scheme’s inception,
around 5% of seafarers have failed 1 1 Able Seaman 19%
10
the enhanced PEME test. Many 2 Chief Cook 15%
9
more seafarers were identified as 3 Oiler 10%
having pre-existing conditions that
8 4 Chief Engineer 9%
required treatment but that were 2

not severe enough to prevent their 5 Engine Fitter 9%

continued sea service. The detection
of their conditions made treatment
and management possible prior
to joining a ship, where it would
have been much more difficult.
Anonymised data gathered by
MRI reveals an interesting picture
of who is failing to obtain an
enhanced PEME certificate:
• Seafarers over the age of
45 dominate nearly all the
condition groups, outnumbering
the younger seafarers.
• The majority of the top ten
conditions can be directly linked
to lifestyle. A healthy lifestyle is
key to preventing conditions that
may cause disruption to members’
activities. Diet and levels of
exercise are decisive factors – this is
especially true for older seafarers.
• Several ranks are overrepresented
within the statistics, including chief
cook, bosun and chief engineer.
Many job roles on board ships are
more sedentary, exposing those
staff to greater risk of lifestyle-
related medical conditions.
7
3 8
6
5 4
This data provides the basis for ship
managers to create health and lifestyle
programmes which can be tailored to
high-risk groups on board their ships.
The top ten reasons for failing the
enhanced PEME include a large number
of medical conditions that were
observed in the claims data research.
This is the best indication of the positive
impact an enhanced PEME scheme
can have on personal illness claims.
Conclusion
Data collection and analysis is a crucial
tool in the fight against preventable
personal illness claims. Claims data
analysis indicated that many personal
illness claims could have been
prevented by enhanced pre-
employment examinations.
6 Bosun 9%
7 Ordinary Seaman 8%
Messman 8%
9 Second Officer 7%
6%
10 Third Engineer
Data drawn from the club’s enhanced
PEME scheme has shown that many
of those who fail to obtain a certificate
within the club’s enhanced PEME
scheme are suffering from very similar
conditions as those observed in the
club’s personal illness claims. This
correlation is crucial to understanding
why the club’s enhanced PEME scheme
is such an important initiative and how
it delivers value for money for club
members.
The data is also useful for members
who can use it to develop their own
policies and initiatives designed to
reduce the likelihood of their seafarers
presenting a personal illness claim.

Unfit group, medical conditions by age group: years 1 to 3

Frequency

77

68

46+
31–45
18–30

45

27
25

19
16 15
14 14
12 12 12 11

5 5 6 5
4 4
2 3 2
1 0 0 0 1 0 0

Hypertension Poor/equivocal Diabetes/ NSSTTW Overweight Sinus tachycardia Heart disease Poor kidney Non-specific Sight issue
(with/without stress test prediabetic/ (changes) function/cyst/ STT changes
meds) elevated chronic kidney
blood sugar disease

Medical conditions

4
5
Seafarer health and operational
effectiveness

A combination of two or more chronic diseases may

pose a high risk of impairing a seafarer’s ability to
fulfil their role on board. In this article, we look at some
specific conditions and the ways these may affect the
seafarer’s ability to carry out their duties or respond to
an emergency situation.

Imagine a notional seafarer Hypertension

Dr Dafna Givati
Senior Flight Medical Officer
and PEME Clinic Auditor,
Medical Rescue International
T +972 52 420 9889
E dafna2200@gmail.com
who is suffering from three
conditions or diseases which
have either been untreated or
poorly treated for some years.
His profile:
• He is obese – Body Mass
Index (BMI) of 33
• He suffers from hypertension
(high blood pressure)
• He has type 2 diabetes.
He has not, up to now, had any real
problems carrying out his duties.
Why therefore may he be a threat
to the safe operation of his ship?
Hypertension, if untreated, can
quietly damage the body for years
before symptoms develop, acting
as a ‘time-bomb’ ticking away. The
areas that it can damage include:
• The arteries: Hypertension can
increase the pressure of the blood
flowing through the arteries, which
can damage the cells of the arteries’
inner lining. The artery walls may
become less elastic, limiting the
blood flow and further increasing
pressure. This can lead to an
aneurism, where a section of the
wall forms a bulge which can rupture
and bleed, most commonly in the
aorta, the body’s largest artery.

Obesity • The heart: Hypertension can lead to

The Standard Club PEME scheme
is designed to facilitate diagnosis
of chronic conditions before they
become dangerous so that
seafarers’ health may be improved,
and shipowners and managers
may be reassured that they are
doing all they can to look after their
crew and maintain the operational
effectiveness of their vessels.
Obesity is one of the major causes,
not only of hypertension and diabetes,
but also of many other conditions,
including coronary artery disease.
Obesity itself affects the ability
to carry out duties when speed of
reaction and agility may be required to
use ladders, enter hatches or access
confined machinery spaces, particularly
in an emergency or bad weather.
coronary artery disease, enlarged
left heart or heart failure. These
conditions increase the risk of heart
attack and sudden cardiac death.
• The brain: Hypertension can lead to
a stroke, where the blood vessels
in the brain may narrow, rupture,
leak or form an aneurism. In the
longer term, it is suspected that
hypertension leads to dementia and
cognitive impairment when there
is reduced blood flow to the brain.

6
• The kidneys: Hypertension is one of
the most common causes of kidney
failure, scarring of the blood vessels
in the kidney or an aneurism of an
artery leading to the kidney. There
can be dangerous internal bleeding
or significant failure of the kidneys
such that dialysis may be required.
• The eyes: High blood pressure
can damage blood vessels leading
to the retina, cause fluid build-up
under the retina or optic nerve
damage. In all cases, there can
be blurred and impaired vision,
or even total loss of vision.
A seafarer with untreated hypertension
is therefore at high risk. As the
condition develops, he will clearly
become less able to carry out duties
and, in the worst case, may fail in his
duties in a safety-critical situation.
Having fallen seriously ill, the ship
may have to divert significantly
from the planned voyage to obtain
treatment or arrange repatriation.
Diabetes
Type 2 diabetes is becoming
more common among seafarers,
and is often linked to obesity, but
not always. It also contributes to
high blood pressure. Prolonged
uncontrolled diabetes can lead to:
• problems with the retina of the
eye, resulting in poor vision
• digestive problems
• kidney disease
• skin problems
• nerve damage
• lack of blood circulation, resulting in:
–– dry skin
–– slow healing of cuts,
burns and wounds
–– fungal and bacterial infections
–– loss of feeling in the foot.
The symptoms of diabetes can be
quite subtle and seemingly harmless,
but if left untreated, can lead to any
or all the diabetic complications.
A combination of conditions
To return to our notional seafarer, if
his conditions are undetected or he is
aware but has not sought treatment,
he may be in danger of suffering any
one of the following problems:
• heart disease leading to heart
failure and heart attack
• stroke involving a brain
aneurism or haemorrhage
• fatigue
• kidney failure
• lack of co-ordination
• pain and depression
• degraded ability to use
the hands and feet
• poor vision.
Depending on his role on board the
ship, any of these problems may affect
his ability to carry out his duties to
varying degrees and detract from the
operational efficiency of the vessel.
He could be a bridge watchkeeper with
deteriorating eyesight or a boatswain
who has lost feeling in one of his hands
or feet, or both; an engineer who
suffers a heart attack or a stroke whilst
the engineer officer of the watch is at
standby; or an officer whose fatigue
is such that he is unable to keep up
with his administrative duties.
Conclusion
The good news is that, if detected early,
the conditions of obesity, hypertension
and type 2 diabetes can be controlled by
a combination of medication, lifestyle
changes and regular medical check-
ups. This means that many seafarers
with such conditions can complete a
full seagoing career provided that early
diagnosis is coupled with compliance
with medication and medical advice.
7
Food for thought
Food quality and quantity are key elements in ensuring
the health of a seafarer. But has the introduction of the
MLC had an impact on the quality of the food or the
health of seafarers?
Glennda Canlas, MD
President/Medical Director,
Halcyon Marine Healthcare Systems
T +632 864 0213
E Glennda.canlas@gmail.com
Global obesity has nearly tripled
since 1975. According to the 2016
statistics of the WHO (World
Health Organization), more than
1.9 billion adults, 18 years and older,
were overweight and 650 million
were obese.1
As of June 2018, cardiovascular
diseases accounted for the most
deaths in the category of non-
communicable or ‘lifestyle’
diseases, with 17.9 million dying
every year.2
8
Regulatory considerations
The introduction of the Maritime
Labour Convention (MLC) 2006 set
clear responsibilities for shipowners/
managers in relation to food for
seafarers. It has three basic principles/
minimum standards regarding
the provision of food on board:
1. Catering staff shall undergo
the necessary training
for their positions.
2. Meals provided should be adequate,
varied, nutritious and served
under hygienic conditions.
3. Food should meet religious
requirements and cultural
practices, and ‘shall be suitable
in respect of quantity, nutritional
value, quality and variety’.
These guidelines are quite general
and open to interpretation in their
implementation depending on the
degree of training and experience of
the cook, and their cultural background.
1 http://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
2 http://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Enforcement and training
Cooks are undergoing formal training
courses that highlight nutrition.
However, will this be an assurance
that the seafarers they cook for will
choose to eat the prepared food that
is good for them? Is it an assurance
that the seafarer will not only eat
the right food but the right amount
as well and avoid overeating when
tired, hungry and stressed?
In addition to the training of cooks,
shipping companies are also
investing in the education of their
seafarers by including health topics
in officers and crew conferences, and
providing educational material prior
to departure and while on board.
The impact (or lack)
Among seafarers, being overweight
or obese and the presence of
other cardiovascular risk factors
(ie smoking, eating an unhealthy
diet) remain common problems
that appear to be on the rise.
Currently, there is no evidence
showing the effect of MLC 2006 on the
quality of food or the health status of
seafarers. It may be more realistic to
look at regulations such as the MLC
2006 as supportive of these choices
rather than relying on them to be
the engine that powers the change
that makes our seafarers healthier.
What is certain is that MLC 2006 alone
will not solve the health issues amongst
seafarers relating to food and lifestyle.
What can seafarers do?
Ultimately, the health of each seafarer
remains primarily with the seafarer
making a personal choice to live a
healthy lifestyle, such as avoiding
unhealthy foods that are high in sugar,
salt, and saturated and trans fats;
eating the right amount to fuel the
body without overeating; choosing
to be more physically active; ceasing
smoking; and dealing with stress
and fatigue in positive ways.
What can shipowners/managers do?
Shipowners/managers can aid
seafarers in their efforts by ensuring
that both the spirit and the letter of
MLC 2006 is implemented on their
vessels and by promoting behaviours
that will benefit the seafarer, such
as moderation and healthy eating.
9
Calorie control
The old adage goes that ‘you are what you eat’.
It certainly is true as our food intake is responsible
for our growth, maintenance, reproduction and
health. So how do you make sure your crew eat
the right quantity of the right things?
Jason Roland N Valdez, MD, MPH
Medical Director
CarePoint Medical Diagnostic
and Wellness Clinic
T +632 354 7022
E carepoint@carepoint.com.ph
Investing in training for the
chief cook will surely pay dividends
in reduced healthcare costs.
10
What to eat?
Food is a mishmash of sugars
(carbohydrates), fats (lipids), proteins,
vitamins and minerals. Carbohydrates
and lipids give us energy, the former
providing ready fuel and the latter
storage. Proteins do most of the work
in our cells and are required for the
structure, function and regulation of
the body’s tissues and organs. Vitamins
and minerals are substances in food
that are necessary for physiological
processes in the body. According to
the Dietary Guidelines for Americans
2015–2020, a healthy eating plan:
• emphasises fruits, vegetables,
whole grains, and fat-free or
low-fat milk and milk products
• includes lean meats, poultry,
fish, beans, eggs and nuts
• is low in saturated fats,
trans fats, cholesterol, salt
(sodium) and added sugars
• stays within your daily calorie needs.
A balanced diet is a healthy diet.
To encourage a healthy lifestyle,
captains can get creative with
‘biggest loser’ contests, crew daily
exercise sessions, and the like.
Ideal body weight
There are many ways to determine
your ideal weight – from a simple
percentile weight-for-height chart to
the more complicated, using calipers
to measure body fat in different
areas of the body. The most common
method is by Body Mass Index (BMI),
which can be derived by the equation:
BMI = Weight in kilograms/(Height in
metres)2.Below is a table of BMI ranges
from the World Health Organization
and specific ranges for Asians – who
make up the majority of seafarers.
WHO Asia-Pacific
(BMI) (BMI)
Underweight <18.5 <18.5
Normal 18.5–24.9 18.5–22.9
Overweight 25–29.9 23–24.9
Obese ≥30 ≥25
How much to eat to maintain Rank Sedentary or light activity Active or moderate activity Vigorously active
ideal weight? (eg, an office worker) (eg, a construction worker) (eg, a farmer)
We can measure food intake by calorie Master
consumption. Different foods have Chief officer
a different number of calories per Second officer
gram of weight. On average, males Third officer
need 2,400 to 2,600 calories per day, Bosun
whereas females need 1,600 to 2,000 Able seaman
calories per day. These averages Ordinary seaman
are affected by physical activity. For Chief engineer
example, the captain on the bridge Second engineer
takes fewer steps per day than an able Third engineer
seaman, so will need fewer calories. Fourth engineer
Other factors that determine calorie Oiler/fitter/machinist
expenditure are gender, age and
Wiper
metabolism. From a survey of marine
Activity correction factor 1.5 1.7 2.2
officers, here are some examples
of the level of activity required to
perform different roles on board: How many calories should you consume to maintain your current weight?
• Men: (weight in pounds x 11) x activity correction factor
• Women: (weight in pounds x 10) x activity correction factor

A healthy lifestyle
Consuming more or less than your
body needs will lead to unhealthy
consequences. Calorie intake should
match your activity level to maintain
weight or be rebalanced accordingly
to help reduce or gain weight.
Climbing a flight of stairs will burn five
calories while walking one kilometre will
burn about 60 calories. A fried chicken
drumstick is about 120 calories, so it
is equal to running four laps around
a VLCC tanker. A cup of white rice is
200 calories, so how many laps would
your crew need to do to burn that?
Junk food will just add to the
daily caloric intake without much
added nutritional value, so should
be avoided. Deep frying in oil will
certainly add calories; thus, the
chief cook is key in improving the
health of all on the ship. Steamed
food, grilled vegetables or Japanese
sashimi are healthy alternatives.
Conclusion
Maintaining a healthy body weight will
reduce risk of heart disease, stroke,
diabetes, some forms of cancer and
joint pains. It will increase energy levels
and optimise the immune system. Make
your crews aware they need to watch
what they eat, but, as with all medical
advice, do everything in moderation.
A 2,000 calorie meal plan for one day from www.eatingwell.com:
Breakfast (417 calories) Afternoon Snack (220 calories)
Avocado-egg toast • 5 tbsp hummus
• 1 slice whole-grain bread • 1 cup sliced cucumber
• 1/2 medium avocado • 2 medium carrots
• 1 large egg, cooked in 1/4 tsp
olive oil or coat pan with a thin Dinner (584 calories)
layer of cooking spray Salmon and vegetables
(1-second spray) Season egg • 4 oz baked salmon
with a pinch of salt and pepper. • 1 cup roasted Brussels sprouts
• 1 medium banana • 1 cup brown rice
• 1/8 tsp salt
Morning Snack (305 calories) • 1/8 tsp pepper
• 1 medium apple • 11/2 tbsp walnuts
• 2 tbsp peanut butter Vinaigrette
• Combine 11/2 tsp each olive oil,
Lunch (468 calories) lemon juice and maple syrup;
• 2 cups ravioli and vegetable soup season with 1/8 tsp salt.
• 2 diagonal slices baguette
(1/4 inch thick), preferably
whole-wheat
• 3 tbsp shredded cheddar cheese
Top baguette slices with 11/2 tbsp
cheese each and a pinch of pepper.
Toast until cheese is melted.
• 1 medium orange

11
Keeping in shape
Victualling in the modern
on boardmaritime industry

Most shipowners now recognise that the provision

of good-quality food is vital to both the physical and
mental wellbeing of their crews. But who should be
providing the ship with provisions to ensure that it
meets these needs?

Several thousand seafarers put food Tight budgets

Yves Vandenborn
Director of Loss Prevention
T +65 6506 2852
E yves.vandenborn@ctplc.com
near the top of their list of things
that currently make them happy,
according to The Mission for Seafarers’
latest Seafarers’ Happiness Index
(Q1 2018). Food scored 6.73 out of 10,
up 8% since last quarter and above
average for happiness rankings.
However, there are still issues
relating to the food chosen
that need to be addressed.
Seafarers’ problems with food
Cultural problems
Regulation 3.2 of the Maritime Labour
Convention (MLC) 2006 requires that
on-board food ‘takes into account
the differing cultural and religious
backgrounds’ of the crew. But according
to The Mission for Seafarers: ‘There
is little evidence, from the responses
received, that this is happening, with
nationals of a range of countries
complaining that their diet did not
reflect the norms of their homelands.’
Nutritional issues
The Mission has also received
complaints about excessive amounts
of fried food and a complete absence
of a policy on volume of fruit and
vegetables. While cooks may have
been ‘trained and qualified’, as
required by MLC, they are clearly not
always serving food of ‘appropriate
quality, nutritional value and
quantity’, which may be related to
the provisions available on board.
There are calls from seafarers to impose
a minimum acceptable spending limit
on crew victualling, which currently
languishes at around $6.00–$8.50 per
head per day. No matter how good
the cook, ‘they need to be supported,
resourced and properly budgeted’,
says The Mission. ‘They need to
combine their own skills with the ability
to buy good-quality ingredients.’
Victualling
This raises the question: who should
buy the food to ensure it meets the
cultural, nutritional and budgetary
requirements? In reality, the shore-
based operations departments of
most major ship managers contract all
provisioning to one or more specialist
ship supply companies. Others,
however, allow self-purchase, with
masters managing the ship’s food
budget directly and sending the cook
out on shopping trips at each port of call.
Self-purchase
Certainly, there are potential
advantages to the self-purchase
option. In theory, it means that all the
victualling budget is being spent on food
rather than on paying fees to supply
companies. It also allows the chief
cook to take full advantage of low local
market prices and to negotiate deals
and discounts directly. Above all, the
cook can pick and choose what they buy,
ensuring only the freshest, highest-
quality produce comes on board.

12
A win-win, one might think. The
reality is that today’s tight operating
schedules and concerns over port
security means that modern ships
rarely spend long in port, leaving very
little time for shopping trips. Cooks
will also need to find additional time in
their already busy daily schedules for
such trips. Furthermore, local markets
vary widely in the range and quality of
food they have available – and may not
even be open on the day a ship calls.
And finally, masters would need to keep
and constantly account for significantly
more cash than usual in the ship’s safe.
There is, of course, a risk that not all
the food cash will actually get spent on
meals for the crew, leading to further
administrative burdens on ship or
shore staff to investigate shortfalls.
Provisioning companies Conclusion
The major provisioning companies A happy, well-fed crew will form the
argue that their bulk-buying of food and basis for a safe and well-run ship.
streamlined delivery makes their prices Shipowners must weigh the pros and
very competitive. They can guarantee cons of each approach to supplying
food quality and quantity, on-time their vessels with the necessary
delivery, MLC compliance and financial provisions and make a choice that
transparency. They also offer online maximises the opportunity for the
victualling systems, menu planning crew to enjoy good-quality food. The
services and catering staff training, and key to success is to employ a great
some even provide the catering staff. cook who serves sufficient healthy
food that the crew enjoys eating.
On the downside, using a provisioning
company requires a significant amount
of planning. Menus need to be planned
well before the ship sails and reordering
needs to be done significantly ahead of
a port call. This gives cooks very little
flexibility to change menus in response
to feedback from crewmembers.
Above all, the provisioning companies
exist to make a profit. Given the
relatively low cost of victualling,
spending this profit on food instead
could make a significant difference to
the size and quality of meals on board.
13
Keeping fit to succeed

A seafarer’s lifestyle choices will directly impact their

health. Exercise is a key component of this equation.
Dr Abaya of Health Metrics Inc. draws on his great
experience of seafarer health matters to make the
case for exercise on board ship. He also provides
details of simple exercises that can be used by
seafarers to help maintain their fitness.

Antonio Roberto M Abaya
Medical Director, Health Metrics Inc
T +632 795 1234
E aabaya@healthmetrics.com.ph
Changes in lifestyle include
both diet and exercise in order
to prevent these so-called
lifestyle diseases.
Keeping fit or staying healthy are
difficult propositions for seafarers,
considering the amount of labour
one goes through on a daily basis.
Physical activity is difficult, and resting
or relaxing seems the easier option
in down-time. A shift in attitude is
required to make seafarers decide to
start exercising, and keep going.
Why exercise
The seafarer must realise that there
is a purpose in keeping fit. So-
called lifestyle diseases can be life-
threatening: hypertension, diabetes,
hyperuricemia and fatty liver disease.
Scientific evidence (Harvard Medical
School, National Institute of Health,
American Heart Association, European
Association for the Study of Diabetes)
has shown that changes in lifestyle can
help to prevent and even slow down or
stop the progression of these diseases.
In addition, when one exercises, there
is a release of the ‘happy hormones’
serotonin and endorphins, promoting
a sense of happiness, well-being and
contentment. Exercise increases
physical and mental stamina, and
is an immediate energy booster.
Hence, with the knowledge that both
diet and exercise may lead us to the
greater good (being disease-free),
it may be easier to appreciate the
sacrifices one endures and make
all the effort seem worthwhile.
How to exercise
One should engage in at least 30
minutes of exercise a day to improve
physical fitness and to provide a
mental break from the daily routine.
A basic cardio workout maintains the
cardiovascular fitness by increasing
heart rate and improving muscle tone.
Where to exercise
Useful basic equipment in the
gyms on board ships includes:
• a treadmill
• basic weights from 2kg up to 10kg
• stretching mats and balls.
Doing exercise with others can help to
maintain motivation and commitment.
Team sports provide a good physical
and mental workout, as these both
improve the cardiovascular system
and promote camaraderie from
team-building in these competitive
sports. Examples could include cricket
(on a large enough ship), basketball,
tug of war or ping pong. However,
one can still do exercises alone.

14
Example routine
Here are eight simple exercises which
managers could promote amongst
their crew. These exercises are easy
and good for confined spaces such
as a cabin. They should take around
eight minutes a day if done properly.
Do each activity for 45 seconds,
resting 15 seconds between
each one and remaining hydrated
throughout:
•  running on the spot
•  jumping jacks
• lunges
•  push-ups
•  mountain climbers
• squats
•  leg raises
•  planks.
If advanced age or the presence of
physical limitations restricts one’s
capacity to do all of these exercises,
walking 10,000 steps a day has been
shown to improve cardiovascular
health. One burns calories and walking
these distances also increases exercise
tolerance. Walking the length of the
ship many times a day can easily
bring one close to the 10,000 steps
or 9 kilometers. If crew members
stick to this goal of 10,000 steps
a day, it adds up to burning about
3,500 extra calories a week, which
is a steady, realistic and achievable
goal. However, any amount of activity
beyond what crew are currently
doing will likely benefit their health.
Conclusion
Whilst seafarers are restricted in what
activities they can engage in because
of the limitations of their environment,
there are many ways to keep fit on
board a ship. These activities can help
reduce the risk of lifestyle-related
diseases. Managers should encourage
seafarers to consider their activity
levels and take the necessary steps to
ensure that they retain a reasonable
state of fitness during their contracts.
Even moderate increases in activity
levels can have a positive impact on the
state of an individual’s health. Simple
exercises such as those listed can mean
the difference between a long career
or one that is cut short by ill health.
15
Keeping in shape on board
The drilling contractor Maersk Drilling has implemented
gyms and exercise facilities for employees on board all
its drilling rigs. The facilities are frequently used and
contribute to the overall welfare of the fleet.
Exercise in the ocean
For offshore workers, working on
board means you won’t always have
access to the luxury of a gym.
But, for a number of years, Maersk
Drilling has offered gym facilities on
board all of its rigs, including dumb bells,
bench press equipment and exercise
bikes. The facilities are popular with
offshore crews and are widely used.
Benjamin Nehammer
Editor & Journalist, Maersk Drilling Fostering a healthy lifestyle
T +45 2921 2604 ‘It is important for Maersk Drilling
E benjamin.moller.nehammer to ensure that we have a healthy
@maerskdrilling.com workforce,’ says Kasper Sottrup-
Jensen, Deputy Asset Manager of
International Jack-ups in Maersk
Drilling. ‘Not only does it help our
employees’ health here and now, it also
helps them lead healthy lives by creating
healthy exercise habits and routines.’
In addition to gyms, some Maersk
Drilling rigs offer a sauna, and all rigs
offer a healthy meal choice for every
meal. Several rigs also have their own
initiatives, such as forming a team to
participate in local running events.
16
Some of Maersk Drilling’s larger rigs
have unique facilities. The Maersk
Guardian, for instance, has a small
basketball court, and the Maersk Giant
is equipped with a badminton court.
Although not all rigs have room for that
kind of exercise facility, every Maersk
Drilling rig offers ample opportunity for
the crew to meet their exercise needs.
The benefits
‘We know that exercise is a great
contributor not only to physical,
but also to mental wellbeing. Quite
simply, exercise contributes to
people’s happiness and health,’ says
Erik Roesen Larsen, Head of Health,
Safety, Security and the Environment
in Maersk Drilling. ‘In a way, exercise
is a kind of basic insurance for people,
something that helps us stay healthy
and engaged for years to come.’
17
Incentivisation, motivation and wellbeing

How can we best motivate our seafarers to maintain

a healthy lifestyle whilst on board? Seafarers have a
greater chance of obtaining their health and fitness
goals if properly motivated.

Enduring habits Incentivisation – reward?

Richard Bell
Loss Prevention Executive
T +44 20 7680 5635
M +44 7919 492 718
E richard.bell@ctplc.com
Seafarers, like most humans, are
creatures of habit. The habits or
lifestyles they lead on board ships
have developed over years of service
at sea, making them comforting and
hard to change. The club’s research
regarding lifestyle-related illness
indicates that poor habits/lifestyles
will often result in medical conditions
that endanger the health and career
of a seafarer. Strategies to change
these habits and alter these patterns
of behaviour can have many benefits.
Why change habits?
Organisations which employ human
beings, regardless of whether they
are shore-based or sea-based, suffer
from the same types of issues. Ill
health and days lost due to sickness
are a drain on an organisation and
reduce operational effectiveness. It
is in the interests of organisations to
promote healthy living to reduce the
incidence of ill health and sick days.
Many shore-based organisations have
been incentivising such behaviour for
years and have been very successful
at reducing these problems.
Reward
Many shore-based companies employ
competition, teamwork and the natural
drive to win, in combination with
financial incentives, to promote specific
desired behaviours. These often take
the form of initiatives or elements of
wellness programmes, for example:
• Weight loss challenges
–– Teams of employees compete to
reach specific weight-loss goals
–– Identifiable rewards
for the winners
• Team sports events
–– Team sports that are
suitable for ships can offer
excellent entertainment for
participating crewmembers
–– Teams drawn from different
departments add an extra
element of competition
–– An organised regular programme
of matches over the course of
a voyage will help to improve
levels of activity, fitness
and social interaction

18
• Fitness-based challenges
–– Teams of employees compete
to attain specific goals
designed to improve fitness
–– Held over a number of weeks
–– Goals could include, pedometer
steps, or miles cycled or run
on exercise bikes/treadmills
–– This type of challenge can
be referenced to a particular
recognisable feature, such
as the first group to cycle the
combined length of ‘Route 66’.
–– Identifiable rewards for the
winners and runners-up
–– An example of this is the
International Seafarers’ Welfare
and Assistance Network’s
(ISWAN’s) Training on Board
initiative, which allows different
ships to compare activity
levels and compete with
each other via the internet
• Smoking cessation programmes
–– Organised programmes to
help workers quit smoking
–– Often involving team-based
programmes for mutual support
–– Various organisations
provide guidance on how to
launch such programmes
–– The British Heart Foundation’s
We quit at work materials
are an excellent example
of such guidance.
Disincentives
A recent trial involving 281 obese
adults showed conclusively that human
behaviour is motivated in predictable
ways. Each of the 281 participants was
tracked for 13 weeks and each was
required to meet a 7,000 steps per
day objective. The participants were
rewarded for successfully meeting
their objectives in different ways:
1. Some participants were simply
told that they had met their goals.
2. Some were entered into
a cash lottery.
3. Another group were given
$1.40 dollars each time
they met their goals.
4. A further group was given an
initial payment of $40 dollars at
the start of the study and were
penalised $1.40 for every day they
failed to meet their objective.
When the results were collated, it was
found that participants in the first three
groups met their goal 30%–35% of
the time, whilst the participants who
‘lost’ money for their failure to achieve
their objective were successful 45%
of the time. The higher achievement
rate for the latter group has been
attributed to participants’ perception
of having experienced a loss, rather
than a gain, and that such negative
incentives may serve to motivate
people in a slightly more effective way.
Studies such as these should
provide food for thought for those
organisations which are considering
ways to reduce obesity and increase the
exercise levels of seafarers. In this case,
the negative incentive could take the
form of deductions from a cash bonus
provided at the start of a contract
for each failure to meet a specific
objective. On the face of it, $1.40/day
appears to be a relatively inexpensive
way to motivate crewmembers and
the theory is backed by solid science.
Conclusion
Seafarers use many methods to adapt
to the rigours of life at sea, some of
these adaptations can be negative,
such as comfort eating. Research
has shown that human behaviour can
be altered by incentives, team spirit
and feelings of accomplishment.
Organisations can harness rewards
or disincentives to get their
crewmembers exercising, eating better
or to quit smoking. If crewmembers
are successfully engaged in such
programmes, it is hoped that the costs
of organising them will be offset by the
reduction in lifestyle-related illnesses
suffered by the crew and therefore the
associated costs for their employers.
19
Seafarer mental health: A rising tide

It is a sad fact that despite the many advances in the area

of seafarer welfare in the last 30 years, the number of
seafarers suffering from mental illness is on the rise.
There is a pressing need to address this problem.

Over the last four years, ISWAN has Risk factors

Ray Barker
Head of Operations, ISWAN
T +44 20 8253 0160
E ray.barker@iswan.org.uk
The International Seafarers’
Welfare and Assistance Network
(ISWAN) is a UK-based charity
which works to promote and
support the welfare of seafarers
globally.
noticed an increase in the number of
seafarers calling our helpline suffering
from a variety of mental health
issues. There is also a consensus
that the number of seafarer suicides
has increased. However, no single
organisation collates such information
and existing data is not regarded as
particularly accurate. One P&I club has
reported that suicide among seafarers
with mental health issues has tripled
since 2014 and that 40% of those who
died were cadets. This trend should be
of grave concern to all stakeholders
within the maritime industry. Tackling
this problem and reversing this trend
should be at the top of the agenda
for those with the power to affect
change in the lives of seafarers.
ISWAN’s experience shows that
working at sea exposes seafarers
to a number of factors that can
push them towards the higher-risk
areas for mental health problems.
These factors include:
1. Social isolation: Long periods
of time spent alone in cabins
allows seafarers to ruminate
over perceived problems.
2. Long voyages: The rigours of life at
sea without a break can take a toll
on even the most robust seafarer.
3. Fatigue due to the watch system:
Lack of rest has been linked to a host
of physical/emotional problems.
4. Separation from family and friends:
Lack of contact with loved ones who
can provide a sympathetic ear in
times of stress can have a profound
impact on some individuals.
5. Increased pressure: Lower crewing
levels places the burden of on-
board tasks on the shoulders
of fewer seafarers, who will
inevitably feel the strain.

20
6. Lack of crew cohesion: Crews
often do not mix socially as they
did only 20 years ago; problems
concerning language and culture
may also exacerbate this problem.
7. Lack of shore leave: Shorter
turnaround times often
deprive seafarers of the
benefits of a run ashore.
8. Harassment and bullying:
Seafarers subjected to bullying
and harassment live in close
proximity to those who are
bullying and harassing them.
9. Precarious employment: With
employment after the completion
of their contracts not guaranteed,
many seafarers experience
anxiety when their current
contracts come to an end.
The good news is that help is out there
Organisations such as ISWAN cannot
resolve the problems of smaller crew
sizes or lack of shore leave, but we
can provide support for seafarers in
need. An effective tool for seafarers
suffering from mental health problems
is emotional support (and if necessary,
counselling) provided remotely. ISWAN
delivers support via a helpline called
‘SeafarerHelp’, which operates 24 hours
per day, 365 days per year for seafarers
and their families. It is available to any
seafarer, or their family, globally.
SeafarerHelp will try to assist with any Conclusion
kind of a problem and can be contacted Whilst there is no easy solution
by email, Facebook, LiveChat, to tackle mental health issues
telephone, Skype, WhatsApp, Viber, amongst seafarers, a combination
SMS text and vk.com. We speak 12 of action by employers and access
different languages including Filipino, to services such as SeafarerHelp
Hindi, Russian, Chinese, Spanish and could hopefully address the trend
Arabic. Operatives have been trained of increased mental illness at sea.
by the Samaritans, counsellors and
a clinical psychologist to further
enhance their skills in these areas.
How can companies help
1. Stigma: General educational
programmes for ship staff
to help remove the stigma
around mental health
2. Training: To help ship staff to
be aware of the signs when
someone is having a mental
health problem, particularly
for officers/senior officers
3. Awareness of resources: Companies
can help promote knowledge of
ISWAN’s SeafarerHelp service
and other organisations that can
provide counselling to seafarers on
board their ships – a list is provided
at the end of this publication.
4. Taking steps to try to address some
of the risk factors that are known
to contribute to mental health
problems amongst seafarers.
21
Post-traumatic stress disorder
(PTSD) and the seafarer
Exposure to traumatic events, be they road traffic
accidents or machinery space fires, may have lasting
consequences. A minority of people exposed to
traumatic events will develop psychological problems,
including post-traumatic stress disorder (PTSD),
whilst most will remain resilient.
What is PTSD?
PTSD is a mental health disorder
which follows exposure to actual or
threatened death, serious injury or
sexual violation. The disorder may
follow a single significant incident or
come on as a result of an accumulation
of traumatically stressful incidents
over time. Some occupations, such
as military personnel or emergency
service workers, are at increased risk
Professor Neil Greenberg of suffering from PTSD. How common
Managing Director, PTSD is in seafarers is unknown.
March on Stress Ltd
T +44 7775 677 859 What are the symptoms?
E info@marchonstress.com There are four groups of
PTSD symptoms:
a) intrusion symptoms such as
recurrent trauma-related thoughts,
nightmares or becoming anxious/
aroused when reminded of the event
b) avoidance of reminders
of the incident
c) negative alterations in cognitions
and mood, which include feeling
emotionally numb or unjustifiably
feeling guilty, shameful or angry
d) alterations in arousal and reactivity,
which include poor sleep, irritability,
jumpiness and being especially
aware of potential threats.
22
Diagnosis
PTSD may be diagnosed when the
above symptoms are present for at
least a month and they substantially
interfere with someone’s ability to
function. PTSD may cause impulsivity
and poor decision-making, and
interfere with sleep leading to fatigue.
Personnel in safety-critical
roles who experience PTSD may
inadvertently cause significant harm;
for example, they may miss warning
indicators, ignore or misinterpret
instructions, or fail to carry out
essential safety checks correctly.
Symptoms that are not functionally
impairing do not amount to a
diagnosis of PTSD. In some cases,
PTSD sufferers may recover without
the need for treatment, but it can
also be a chronic and debilitating
condition associated with significant
social impairment and a range of
other mental and physical health
problems, as well as substance abuse.
Case study
A crewmember unsuccessfully tries
to resuscitate a colleague crushed
by a container after a hydraulic lift
failure. The crewmember quickly finds
that they cannot stop thinking about
the incident and have nightmares
about it, often waking in a sweat.
They avoid going on the upper deck
anywhere near the location of the
accident. They cannot concentrate
on their usual tasks, and are
constantly jumpy and on edge in
case another incident might occur.
They do not speak to their colleagues
about the incident because doing
so distresses them. Also, they
begin covertly drinking spirits in
an attempt to get some sleep.
Conclusion
Shipowners should be aware that
trauma-exposed crew may develop
PTSD. Officers should monitor
the behaviour of trauma-exposed
crewmembers and sensitively ask
about their well-being a month or so
after an incident. Those who might
be affected should be encouraged
to seek a professional assessment.
Unfortunately, evidence shows that
most people with PTSD do not seek
help until their life falls apart or a crisis
occurs. However, effective treatment
can improve health and maintain
someone’s ability to work at sea.

Over time, their symptoms get worse.

Two months after the incident, they
ask to be landed at the next port. It is
only when an officer asks what’s wrong
that the individual, uncharacteristically,
breaks down in tears and explains
the reasons for their predicament.

23
Why screening does not work but peer
support does
Mental health issues amongst seafarers seem to be
increasing. While screening for potential vulnerability
may seem like an attractive option, it may simply not
work.
Professor Neil Greenberg
Managing Director,
March on Stress Ltd
T +44 7775 677 859
E info@marchonstress.com
24
Seafarer mental health
Mental health in the workplace is
currently a hot topic. Evidence collected
from maritime organisations has
highlighted that seafarers may be
considered an especially ‘at risk’ group.
For instance, between 1960 and 2009,
around 6% of seafarer deaths were due
to suicide1. This figure excludes those
who ‘disappeared’ at sea, many of whom
are likely to have taken their own life.
However, whilst tragic, suicide is likely
to be only the tip of the mental health
iceberg, with cases of depression,
post-traumatic stress disorder (PTSD)
and other anxieties disorders (together
referred to as common mental health
disorders or CMHDs) being likely to
both be a cause of sickness absence
and poor performance on board.
The importance of screening
Given the increasing awareness of
mental health disorders in seafarers, it
is perhaps not surprising that screening
personnel for potential vulnerability to
develop mental health problems may
seem like an attractive option. Selection
screening refers to the administration
of some combination of questionnaires
and/or formal assessments by a mental
health professional in order to identify
who is, or is not, suited to be at sea.
Valid and reliable pre-screening would
allow unsuitable prospective seafarers
to avoid risking their mental health, help
avoid costly mental health repatriations
and reduce the risk of mental health
related poor performance, and the
consequential risk of accidents.
The failure of screening
However, evidence2 from high-
quality studies carried out in other
occupational groups, most notably the
armed forces, has shown that selection
screening processes do not work. For
instance, a screening trial of British
military personnel deployed to the Iraq
War in 2003 found that a pre-screening
process to prevent troops developing
PTSD was wrong four times out of five.
Importantly, screening failed to identify
the majority of those who went on to
suffer PTSD and was equally ineffective
for other CMHDs. The reasons for
the failure of a pre-screening process
are varied but include personnel
not wishing to answer questions
about their psychological health
honestly because they fear being
stigmatised or suffering a career foul.
1. Iversen RTB. The Mental Health of Seafarers.
International Maritime Health 2012;63(2):78-89
2. Rona R, Jones M, Hooper R, Hull L, Browne T,
Horn O, Murphy D, Hotopf M and Wessely, S.
Mental health screening in armed forces before
the Iraq war and prevention of subsequent
psychological morbidity: follow-up study.
BMJ 2006; 333: 991-995
Also, pre-screening does not take
account of the strong evidence that
good social support and effective
supervision whilst on board a vessel
are far more important predictors of
mental health status than whether
someone had a poor childhood,
is poorly educated or has a prior
history of a mental health disorder.
There is very good evidence that
effective social support provided by
colleagues, and more importantly
a seafarer’s day-to-day supervisor,
strongly influences their mental health.
For instance, evidence from British
troops deployed to Afghanistan
over the last ten years showed that
personnel who reported being well led/
supervised experienced one-tenth
the rate of PTSD when compared
with less well-led colleagues.
Structured peer support programmes,
and managerial mental health
training, have been shown to be
effective in numerous challenging
occupations such as the emergency
services, the media, diplomatic
service and the military.
Perhaps now is the time for
maritime organisations to invest
in similar initiatives and reap the
benefits for both shipowners and
the crews who man the vessels.
Conclusion
Gone should be the attempts to screen
out vulnerable individuals; such efforts
are ineffective and highly imprecise.
Instead, there should be investment in
ensuring that a ship’s crew is enabled
to properly support each other and to
identify those who need professional
help, which is a powerful approach to
improving team resilience and one
backed by strong scientific evidence.
25
The risks and rewards of seafaring
in the digital age

It is impossible to ignore how much the proliferation

of the internet and social media has changed the way
people interact and communicate. Seafarers are not
immune to these changes. How has the introduction
of internet on board ships changed the social cohesion
between seafarers?

In just 25 years, the number of internet The Mission to Seafarers’ latest

users has grown from a few million to
more than four billion – over half the
total population. Advances in satellite
communications mean that the
proportion is even higher on ships, with
75% of the world’s seafarers now online.
Seafarers’ Happiness Index
(Q1 2018) confirms that being in
contact with their family while at sea
makes seafarers happier than anything
else. They scored it 7.12 out of 10,
7% higher than for the last quarter.

Yves Vandenborn
Director of Loss Prevention
T +65 6506 2852
E yves.vandenborn@ctplc.com
When you set sail back in the 1990s,
keeping in touch with family and friends
usually meant a brief but expensive
long-distance telephone call from port
every few weeks or receiving a stack
of ‘snailmail’ once a month. Socialising
on board was not just limited to a
drink with other crewmembers in the
bar before dinner, but also included a
video or ping-pong match afterwards.
Not to forget about karaoke!
But with on-board wi-fi, you can now
stay in constant contact with your
loved ones, sharing every moment
of each other’s lives. You can also
watch television and download
new books, music, films and games
without leaving your cabin.
Importance of connectivity
Certainly, seafarers like connected
ships. According to Futurenautics’
Crew Connectivity 2018 Survey Report,
internet access strongly influences
the decision of 92% of seafarers
on where to work. Most (95%) see
connectivity as having a positive
effect on on-board safety too.
However, in terms of importance,
seafarers rank internet provision just
fifth out of six services provided by
shipowners. Pay, benefits, training and
food are all considered more important,
with only entertainment less so.
Effect on social interaction
On the down side, over half (53%)
of seafarers now believe that
increased connectivity has led to
a decline in social interaction with
their fellow crewmembers. Indeed,
happiness from interaction with
other crew has fallen 13% over the
last quarter to 7.08 out of 10.
The Mission to Seafarers is quick
to point out that correlation is not
the same as causation; ‘With ever
smaller crew numbers, with single
occupancy cabins and the fact
that ships do not always have a bar
anymore to serve as the hub of activity,
then it is perhaps too easy to think
that online access is the reason for
people retreating into isolation.’

26
Cultural differences, gender
and racial discrimination, and
increased separation of shipboard
work areas are cited as more
obvious barriers to interaction.
Opportunities for shipowners
There is no doubt from a shipowner’s
perspective that the opportunities
offered by increased connectivity are
many – and go well beyond the original
aim of improving crew communications.
Shore-staff can become far more
involved with the operation of
permanently connected ships, from
real-time monitoring of engine and
machinery performance to visual feeds
of mooring and loading. They are also
one step closer to unmanned ships.
In the meantime, maintaining the health
and welfare of the dwindling population
on each ship remains vital. Any
concerns about the negative impact of
connectivity on mental well-being need
addressing as a matter of urgency.
Ideas for improvement
One suggestion that surfaced in the
Futurenautics report is reviving the idea
of the ‘internet cafe’. Restricting online
access to communal areas (and possibly
certain times of day) would create a link
between communicating with home
and communicating with colleagues.
It would definitely help prevent
seafarers being constantly distracted
by their mobile devices while working,
particularly if there is an ongoing
problem back home. It would also
mean good and bad news can be
immediately shared and discussed,
rather than bottled up or forgotten.
Communal internet areas could also be
fitted out with bigger, higher-quality
screens, which are still more enjoyable
to watch than those on hand-held
devices. Online entertainment such
as live sports coverage, new movies
or multi-player video games can
then be enjoyed as a group activity.
Last but not least, consideration could
be given to controlled provision of
low-strength alcoholic drinks (together
with non-alcoholic equivalents) in
communal internet areas as a further
incentive for crewmembers to emerge
from the isolation of their cabins.
Cyber resilience
Just under half (46%) of seafarers
say they have sailed on a vessel
that has been compromised by a
cyber attack1. This is a threat that
will only grow as connectivity
increases.
It is essential for cyber security
and resilience to be embedded in
all shipboard operations, systems
and training, with full advantage
taken of free industry initiatives
such as ‘Be Cyber Aware at Sea’.
Conclusion
The world is only just beginning to
experience the transformative and
disruptive effects of the digital age.
Far bigger changes are just around the
corner, which for the shipping sector
could mean fully autonomous vessels
that can do everything for themselves.
These transitions will not be painless
– each new technology will require
an adjustment to how we do things.
For example, on-board connectivity
makes seafarers much happier
but appears to undermine social
cohesion. This might be fixed by
using technology to control where
and when online access is available
and to bring seafarers together.
As Futurenautics head, K D Adamson,
points out, ‘the real value of technology
comes when you deploy it intelligently’.

It should be clear that access to

personal devices to check emails or
social media apps or communicate
with family/friends should be
prohibited on the bridge, engine
room, cargo control room or other
sensitive areas where the crew’s
attention should be 100% focused
on the job.

1 Futurenautics, Crew Connectivity 2018 Survey

Report

27
The human element
– the effects of fatigue on ship safety
PART 2 – Practical advice to the seafarer
The human element is often cited as a
major cause of marine incidents. Fatigue
is the main contributory factor in such
incidents. 82% of the recorded groundings
and collisions occurring between 0000 and
0600 hours are caused by fatigue.¹
Andrew Russ
1 UK Marine Accident Investigation Branch
(MAIB), Bridge Watchkeeping Safety Study, 2004
2 International Maritime Organization (IMO),
MSC/Circ.813/MEPC/Circ.330, List of Human
Element Common terms, 1997
3 Comparison of the relative effects on
performance of sleep deprivation and alcohol,
by A.M. Williamson & A-M Feyer, 2000
4 National Health Service, UK (NHS),
Sleep and tiredness, why lack of sleep
is bad for your health, 2018
5 Warsash Maritime Academy, Southampton
Solent University and the Stress Research
Institute, University of Stockholm,
Investigation of the 8-hours on/8-hours off
seafarer watch keeping system, a final report to
the UK Maritime and Coastguard Agency, 2016
28
Introduction
Fatigue is not a new issue for
seafarers. However, in recent
years, it has increased due to:
• greater commercial pressure
• quicker turnarounds
• more efficient port facilities
• reduced manning
• the depressed economic state
of the marine industry.
It is paramount for all seafarers to fully
understand fatigue, how it is caused
and what can be done to prevent
or at least minimise its effects.
What is fatigue?
Fatigue is considered as ‘A reduction in
physical and/or mental capability as the
result of physical, mental or emotional
exertion which may impair nearly all
physical abilities including: strength;
speed; reaction time; co-ordination;
decision making; or balance’.²
The effect of fatigue
on human performance
Medical research has proven how
dramatically fatigue can influence an
individual’s ability to carry out day-to-
day duties. Approximately 22 hours of
wakefulness is equivalent (in relation to
impairment of performance) to having
a blood-alcohol concentration of 0.1%.³
This is double the legal driving limit in
most EU member states. It can also lead
to long-term health conditions such
as obesity, cardiovascular disease and
diabetes.⁴ It is clear that eliminating
fatigue is paramount for both the
shipowner and the crewmember.
What action can be taken by
the ships’ staff to prevent or
reduce levels of fatigue?
Outside of efforts undertaken by
shipowners and industry bodies,
there are measures that can be taken
by the seafarers themselves to reduce
occurrences of fatigue, which should
be encouraged by managers.
Management of work periods
Although responsibility for a ship’s
compliance to STCW has now been
placed on shipowners (to provide the
necessary resources and manning
levels), final responsibility stills remains
with the ship’s master.
The use of the ‘6 on 6 off’ watch system
has proven to increase fatigue and
stress levels.⁵ Forward planning by
masters, whenever possible, to
minimise periods where this watch
system is required is essential.
Management of rest periods
Modern technology allows seafarers to
readily communicate with friends and
family ashore, watch movies and play
video games in the comfort of their
own cabin. Whilst this is an advantage,
seafarers should take care to ensure
that they don’t unduly disrupt their rest
hours with such diversions. The ease of
communication with home can result in
unfiltered news, sometimes bad, being
received, leading to increases in stress
levels.
Optimum contract lengths
Individual seafarers’ contracts
vary considerably, despite all
being compliant with MLC 2006
limitations.⁶ An optimum contract
length would be three to six months,
significantly less than the MLC
limitation. Contracts of over
six months may result in sleeplessness,
loss of sleep quality and reduced
motivation, leading to fatigue and
stress.⁷⁸
Seafarers, not only owners/managers,
should be active in determining the
length of their contract. The extension
of contracts to over 11 months
should be discouraged.9
Suitable vacation periods between
contracts
Seafarers need to take accountability
for ensuring suitable leave periods
to avoid stress or fatigue-related
long-term illnesses. Research indicates
that leave periods cannot be calculated
from a generic equation, as recovery
time between voyages is dependent
on many variables such as rank,
watchkeeping patterns, ship design,
trading pattern and workloads,
and ultimately the well-being of
the individual seafarer.⁷⁸⁹
Fully embrace and utilise new
innovations to help reduce fatigue
These schemes need seafarers’
support for shipowners/managers to
be able to identify where any significant
beneficial changes can be made.
Weather routing
Utilising effective weather
routing to avoid adverse weather
provides a more comfortable
living environment, ensuring that
crewmembers get sufficient
sleep during rest periods.
Fatigue Risk
Management Systems
Fatigue Risk Management Systems
(FRMSs) are being introduced into the
marine industry, having already had
considerable success in other safety-
critical industries. FRMSs are designed
to assist in identifying shortfalls in
existing company procedures as well
as international regulations and what
amendments should be made to
address them.
FRMSs use a comprehensive,
systematic approach by reviewing
all aspects of the workplace, including
operational requirements/restrictions,
quality assurance as well as company
procedures. The standard core
elements being implemented
across the industry are:⁷⁸
• fatigue awareness training and
cultural change programmes
• a fatigue reporting system
within a just culture
• data-driven analysis for operational
fatigue risk assessment, workload
management and monitoring
of adequate sleep for seafarers
For FRMSs to be truly effective, it
will require full commitment from
shipowners, shoreside personnel
as well as seafarers.
Maintaining seafarers’ standard
of health
Seafarers need to understand
the link between fatigue and ill health.
Long-term fatigue can lead to reduced
work performance, ill health and
reduced lifespan. Seafarers can take
positive steps to help minimise the
effects of fatigue on their health by
prioritising rest during off-watch
periods over other on-board activities.
Conclusions
A full understanding of fatigue, how it
is caused and the ability to recognise
the symptoms is of paramount
importance for all seafarers and
particularly the master. Pre-emptive
action should be encouraged:
• maintain a healthy diet
and exercise routine
• ensure prejoining medicals are
comprehensive and all, if any,
medicines being taken are disclosed
• ensure a good understanding
of fatigue and know how to
identify the symptoms
• ensure that crew feel able to advise
senior officers if they believe
they are suffering from fatigue
• avoid extensions past
11-month contracts
• ensure adequate leave to allow
crew to fully regain normal physical
health before returning to sea.
6 MLC 2006
7 Project Horizon, 2012
8 Project Martha, 2013–2016
9 Occupational Safety and Health Research
Institute, USA, Sleep and Fatigue Among
Seafarers: The Role of Environmental Stressors,
Duration at Sea and Psychological Capital, 2016
29
Charities which can provide
support for seafarers

International Seafarers Welfare and Assistance Network

Web: www.seafarerhelp.org

Mission to Seafarers
Tel: +44 20 7248 5202 (will redirect to an on-call number if out of hours)
Email: crewhelp@mtsmail.org
Web: www.missiontoseafarers.org

Seafarers Hospital Society

Web: https://seahospital.org.uk/mental-health-and-wellbeing-2/

Sailors Society
Trained chaplains can be contacted on:
Africa Rev J.D. van Schalkwyk: +27 31 266 0695
Asia Gavin Lim: +65 9222 4600
Europe Alexander Dimitrevitch: +380 503 366 790
India Manoj Joy: +91 9884 140 950
The Philippines Iris Picardal: +63 9175 782 118
Email: crisis@sailors-society.org

The Standard Club has no affiliation with the above organisations. The listing of organisations should not be regarded as a
recommendation, rather an indication of the types of charities/organisations available to support seafarers.

30
Commercial organisations which can
provide services related to seafarer welfare

March on stress
Email: info@marchonstress.com

CONOVAH ApS Health and Safety Solutions

Tel: +45 4014 1084
Email: info@conovah.com
Web: conovah.com

WellAtSea
Email: info@wellatsea.com
Tel: +45 2714 0707

Future Care Inc.

Caring for the Crew® Program – Global Medical Advice Contact Center:
Email: firstresponse@futurecareinc.com
This email address is monitored by first responders 24/7 and should be
utilized to request non-emergency port side medical appointments
Call line: +1 917 579 0257
Alternate line: +1 917 432 2400
Call line phone numbers are for medical emergency assignments only

The Standard Club has no affiliation with the above organisations. The listing of organisations should not be regarded as a
recommendation, rather an indication of the types of charities/organisations available to support seafarers.

31
The Standard Club issues a variety of publications and web alerts on topical issues and club updates.
Keep up to date by visiting the news section on our website www.standard-club.com

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